Court Navigators and Opportunities for Disseminating Overdose Prevention Strategies

Abstract

Objective. Describe how navigator programs from three New England states (Connecticut, Maine, and Massachusetts) function to connect individuals using court services to community-based treatment and services. Hypothesis. Implementation science frameworks can be used to analyze how multiple court programs function to inform replication and address gaps in the use of overdose prevention strategies. Method. The Template for Intervention Description and Replication (TIDieR) Implementation informed semi-structured interviews as part of an exploratory mixed-methods analysis of court navigator programs. Analysis of interviews based on the TIDieR and administrative data on client contacts (n = 436) were analyzed. A subsample of clients with additional background information (n = 249) was used to examine court navigator recommendations. Results. The TIDieR revealed court navigator programs shared basic intervention characteristics but varied dramatically by resources and organization contexts. Nearly half (46.5%) of clients were self-referred and more than two-thirds (69.1%) approved follow-up but varied by program. Of those allowing follow-up, more than one-third (35.7%) had previously experienced an overdose. Court navigators were significantly more likely to refer clients with a history of overdose to locations where they can receive naloxone (the opioid overdose antidote) though only one program had naloxone on hand. Conclusion. Navigators are employed by community organizations with access to courthouses to provide resources to those passing through. These efforts can be implemented to support linkages to treatment and services but there is a significant gap in the allocation of overdose prevention strategies in court settings and court navigator programs have the potential to address this unmet need.

Keywords

court navigator substance use disorder overdose prevention harm reduction implementation science court programming

Get full access to this article

View all access options for this article.

References

Alvarez

Cerritelli

Urrutia

(2016). Using the template for intervention description and replication (TIDieR) as a tool for improving the design and reporting of manual therapy interventions. Manual Therapy, 24, 85–89.

Bell

L. A.

Hadland

S. E.

(2023). Unintentional overdoses: Understanding the fentanyl landscape and reducing harm. Current Opinion in Pediatrics, 35, 408–414.

Best

A. F.

Haozous

E. A.

Berrington

Gonzalez

Chernyavskiy

Freedman

N. D.

Hartge

Thomas

Rosenberg

P. S.

Shiels

M. S.

(2018). Premature mortality projections in the USA through 2030: A modelling study. The Lancet Public Health, 3(8), e374–e384. https://doi.org/10.1016/S2468-2667(18)30114-2

Brinkley-Rubinstein

Macmadu

Marshall

B. D. L.

Heise

Ranapurwala

S. I.

Rich

J. D.

Green

T. C.

(2018). Risk of fentanyl-involved overdose among those with past year incarceration: Findings from a recent outbreak in 2014 and 2015. Drug and Alcohol Dependence, 185, 189–191. https://doi.org/10.1016/j.drugalcdep.2017.12.014

Brinkley-Rubinstein

Zaller

Martino

Cloud

D. H.

McCauley

Heise

Seal

(2018). Criminal justice continuum for opioid users at risk of overdose. Addictive Behaviors, 86, 104–110. https://doi.org/10.1016/j.addbeh.2018.02.024

Campbell

N. D.

(2021). Enacting fentanyl tests strips for overdose prevention: The socio-material transformation of “suspect technologies” into “technologies of solidarity.” Contemporary Drug Problems, 48(4), 305–326.

Childs

Biello

K. B.

Valente

P. K.

Salhaney

Biancarelli

D. L.

Olson

Earlywine

J. J.

Marshall

B. D. L.

Bazzi

A. R.

(2021). Implementing harm reduction in non-urban communities affected by opioids and polysubstance use: A qualitative study exploring challenges and mitigating strategies. International Journal of Drug Policy, 90, 103080. https://doi.org/10.1016/j.drugpo.2020.103080

Ciccarone

(2021). The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis. Current Opinion in Psychiatry, 34(4), 344–350. https://doi.org/10.1097/YCO.0000000000000717

Clear

T. R.

Rose

D. R.

Waring

Scully

(2003). Coercive mobility and crime: A preliminary examination of concentrated incarceration and social disorganization. Justice Quarterly, 20(1), 33–64.

10.

Del Pozo

Beletsky

Goulka

Kleinig

(2021). Beyond decriminalization: Ending the war on drugs requires recasting police discretion through the lens of a public health ethic. The American Journal of Bioethics, 21(4), 41–44.

11.

Desrosiers

P. L.

Mallinger

Bragg-Underwood

(2016). Promoting socially just healthcare systems: Social work’s contribution to patient navigation. Advances in Social Work, 17(2), 187–202.

12.

Division

(2021, December 8). SAMHSA announces unprecedented $30 million harm reduction grant funding opportunity to help address the nation’s substance use and overdose epidemic. HHS.Gov. https://www.hhs.gov/about/news/2021/12/08/samhsa-announces-unprecedented-30-million-harm-reduction-grant-funding-opportunity-help-address-nations-substance-use-overdose-epidemic.html

13.

Dunlap

(2013). Anyone can think like a lawyer: How the lawyers’ monopoly on legal understanding undermines democracy and the rule of law in the United States. Fordham Law Review, 82, 2817.

14.

Enos

(2021). An improved funding picture spells hope for harm-reduction workforce. Alcoholism & Drug Abuse Weekly, 33(18), 1–8.

15.

Ezer

(2017). Medical-legal partnerships with communities: Legal empowerment to transform care. Yale Journal of Health Policy, Law, and Ethics, 17, 309–326.

16.

Farago

Blue

T. R.

Smith

L. R.

Witte

J. C.

Gordon

Taxman

F. S.

(2023). Medication-assisted treatment in problem-solving courts: A national survey of state and local court coordinators. Journal of Drug Issues, 53(2), 296–320. https://doi.org/10.1177/00220426221109948

17.

Fisher

O’Donnell

Ray

Rusyniak

(2016). Police officers can safely and effectively administer intranasal naloxone. Prehospital Emergency Care, 20(6), 675–680. https://doi.org/10.1080/10903127.2016.1182605

18.

Furr-Holden

Milam

A. J.

Wang

Sadler

(2021). African Americans now outpace whites in opioid-involved overdose deaths: A comparison of temporal trends from 1999 to 2018. Addiction, 116(3), 677–683. https://doi.org/10.1111/add.15233

19.

Grella

C. E.

Ostlie

Scott

C. K.

Dennis

M. L.

Carnevale

Watson

D. P.

(2021). A scoping review of factors that influence opioid overdose prevention for justice-involved populations. Substance Abuse Treatment, Prevention, and Policy, 16(1), 19. https://doi.org/10.1186/s13011-021-00346-1

20.

Han

B. H.

Williams

B. A.

Palamar

J. J.

(2021). Medical multimorbidity, mental illness, and substance use disorder among middle-aged and older justice-involved adults in the USA, 2015–2018. Journal of General Internal Medicine, 36(5), 1258–1263. https://doi.org/10.1007/s11606-020-06297-w

21.

Harper

Riddell

C. A.

King

N. B.

(2021). Declining life expectancy in the United States: Missing the trees for the forest. Annual Review of Public Health, 42(1), 381–403. https://doi.org/10.1146/annurev-publhealth-082619-104231

22.

Hedegaard

Spencer

M. R.

Garnett

M. F.

(2020). Increase in drug overdose Deaths involving Cocaine: United States, 2009-2018. NCHS Data Brief, (384), 2020.

23.

Hermans

S. P.

Samiec

Golec

Trimble

Teater

Hall

O. T.

(2023). Years of life lost to unintentional drug overdose rapidly rising in the adolescent population, 2016–2020. Journal of Adolescent Health, 72(3), 397–403. https://doi.org/10.1016/j.jadohealth.2022.07.004

24.

Hoffman

A. S.

Volk

R. J.

Saarimaki

Stirling

L. C.

Härter

Kamath

G. R.

Llewellyn-Thomas

(2013). Delivering patient decision aids on the Internet: Definitions, theories, current evidence, and emerging research areas. BMC Medical Informatics and Decision Making, 13(S2), Article S13. https://doi.org/10.1186/1472-6947-13-S2-S13

25.

Hoffmann

T. C.

Glasziou

P. P.

Boutron

Milne

Perera

Moher

Altman

D. G.

Barbour

Macdonald

Johnston

Lamb

S. E.

Dixon-Woods

McCulloch

Wyatt

J. C.

Chan

A.-W.

Michie

(2014). Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. BMJ, 348, Article g1687. https://doi.org/10.1136/bmj.g1687

26.

Larochelle

M. R.

Bernstein

Bernson

Land

Stopka

T. J.

Rose

A. J.

Bharel

Liebschutz

J. M.

Walley

A. Y.

(2019). Touchpoints—Opportunities to predict and prevent opioid overdose: A cohort study. Drug and Alcohol Dependence, 204, 107537. https://doi.org/10.1016/j.drugalcdep.2019.06.039

27.

Magee

L. A.

Fortenberry

J. D.

Rosenman

Aalsma

M. C.

Gharbi

Wiehe

S. E.

(2021). Two-year prevalence rates of mental health and substance use disorder diagnoses among repeat arrestees. Health & Justice, 9(1), 2. https://doi.org/10.1186/s40352-020-00126-2

28.

Mancher

Leshner

A. I.

; Medication-Assisted Treatment for Opioid Use Disorder (Eds.). (2019). Medications for opioid use disorder save lives. National Academies Press (US).

29.

Miller

M. K.

Block

L. M.

DeVault

(2020). Problem-solving courts in the United States and around the world: History, evaluation, and recommendations. In Miller

M. K.

Bornstein

B. H.

(Eds.), Advances in psychology and law (Vol. 5, pp. 301–371). Springer. https://doi.org/10.1007/978-3-030-54678-6_9

30.

Park

J. N.

Rashidi

Foti

Zoorob

Sherman

Alexander

G. C.

(2020). Fentanyl and fentanyl analogs in the illicit stimulant supply: Results from U.S. drug seizure data, 2011–2016. Drug and Alcohol Dependence, 218, 108416. https://doi.org/10.1016/j.drugalcdep.2020.108416

31.

Phalen

Ray

Watson

D. P.

Huynh

Greene

M. S.

(2018). Fentanyl related overdose in Indianapolis: Estimating trends using multilevel Bayesian models. Addictive Behaviors, 86, 4–10. https://doi.org/10.1016/j.addbeh.2018.03.010

32.

Ray

Christian

Bailey

Alton

Proctor

Haggerty

Lowder

Aalsma

(2023). Antecedents of fatal overdose in an adult cohort identified through administrative record linkage in Indiana, 2015-2022. Drug and Alcohol Dependence, 247, 109891.

33.

Ray

Richardson

N. J.

Attaway

P. R.

Smiley-McDonald

H. M.

Davidson

Kral

A. H.

(2023). A national survey of law enforcement post-overdose response efforts. The American Journal of Drug and Alcohol Abuse, 49, 199–205.

34.

Reed

M. K.

Salcedo

V. J.

Hsiao

Esteves Camacho

Salvatore

Siegler

Rising

K. L.

(2023). Pilot testing fentanyl test strip distribution in an emergency department setting: Experiences, lessons learned, and suggestions from staff. Academic Emergency Medicine, 30, 626–635.

35.

Rhode

D. L.

(2015). What we know and need to know about the delivery of legal services by nonlawyers. South Carolina Law Review, 67, 429.

36.

Russell

Johnson

Kosinski

Kaplan

Barnes

Allen

Haroz

(2023). A scoping review of implementation considerations for harm reduction vending machines. Harm Reduction Journal, 20(1), 33. https://doi.org/10.1186/s12954-023-00765-2

37.

Sandefur

R. L.

Clarke

(2016). Roles beyond lawyers: Summary, recommendations and research report of an evaluation of the New York City Court Navigators Program and its three pilot projects (SSRN Scholarly Paper 2949038). https://doi.org/10.2139/ssrn.2949038

38.

Sen

(2019). Beyond the JD: How eliminating the legal profession’s monopoly on legal services can address the access-to-justice crisis. University of Pennsylvania Journal of Law and Social Change, 22, 121.

39.

Shefner

R. T.

Sloan

J. S.

Sandler

K. R.

Anderson

E. D.

(2020). Missed opportunities: Arrest and court touchpoints for individuals who fatally overdosed in Philadelphia in 2016. The International Journal on Drug Policy, 78, 102724. https://doi.org/10.1016/j.drugpo.2020.102724

40.

Sugarman

O. K.

Hulsey

E. G.

Heller

(2023). Achieving the potential of naloxone saturation by measuring distribution. JAMA Health Forum, 4(10), Article e233338.

41.

Szalavitz

(2021). Undoing drugs: The untold story of harm reduction and the future of addiction. Hachette Go.

42.

Victor

Zettner

Huynh

Ray

Sightes

(2021). Jail and overdose: Assessing the community impact of incarceration on overdose. Addiction, 117, 433–441.

43.

Wexler

D. B.

Winick

B. J.

(1991). Essays in therapeutic jurisprudence. Carolina Academic Press.

44.

Winhusen

Walley

Fanucchi

L. C.

Hunt

Lyons

Lofwall

Brown

J. L.

Freeman

P. R.

Nunes

Beers

(2020). The opioid-overdose reduction continuum of care approach (ORCCA): Evidence-based practices in the HEALing communities study. Drug and Alcohol Dependence, 217, 108325.

45.

Winkelman

T. N. A.

Kieffer

E. C.

Goold

S. D.

Morenoff

J. D.

Cross

Ayanian

J. Z.

(2016). Health insurance trends and access to behavioral healthcare among justice-involved individuals—United States, 2008–2014. Journal of General Internal Medicine, 31(12), 1523–1529. https://doi.org/10.1007/s11606-016-3845-5

46.

Woolf

S. H.

Wolf

E. R.

Rivara

F. P.

(2023). The new crisis of increasing all-cause mortality in US children and adolescents. JAMA, 329(12), 975–976.

47.

Zeng

(2022). Jail inmates in 2021—Statistical tables. Bureau of Justice Statistics. https://Bjs.Ojp.Gov/Library/Publications/Jail-Inmates-2021-Statistical-Tables

48.

Zeng

Minton

T. D.

(2021, March). Jail inmates in 2019 (NCJ 255608). U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. https://bjs.ojp.gov/content/pub/pdf/ji19.pdf

49.

Zorza

Udell

(2013). New roles for non-lawyers to increase access to justice. Fordham Urban Law Journal, 41, 1259.

50.

Zottola

S. A.

Morrissey

Massey

Hope

E.C.

Desmarais

S. L.

(2023). A national compendium of court navigation programs. Policy Research Associates.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.01 MB